Your opinions on GDC reform

on 29 August 2014

Having recently graduated in July this year, the prospect of entering the world of general dental practice is both exhilarating and exciting. Yet, the reality is that both the reduction in dental foundation training salary and the significant rise in the General Dental Council's (GDC’s) annual retention fee (ARF) will have a dampening effect on newly qualified dentists.

The GDC’s justification for the substantial increase in the annual retention fee is to enable them to deal with the influx of complaints that have amassed over the last three years (a staggering 110% rise).

An article in the latest Riskwise UK by Dental Protection, found that the number of litigation cases from January to April of 2014 had already vastly exceeded those recorded for the whole year of 2012; there is a possibility that unless a solution is found this trend could continue.

Having read several of the GDC reform letters on Dentistry.co.uk, it is clear that the profession as a whole is furious with the plans made by the GDC. A 64% rise in the ARF for dentists is a difficult pill to swallow.

Seema Sharma in her GDC reform letter stated that it is important 'to identify the root cause'. Similarly, Michael Watson emphasised that 'it has made no analysis of the reasons for this increase'.

The Local Dental Committees of the midlands, north, west and east of England wrote a GDC reform letter and questioned if there may be a link with the rise in complaints, and the 57% increase in overseas graduates since 2006. They go on to say that more support should be offered to such graduates as they are ‘often left to get on with it’.

Likewise, Peter Thomson expressed concern in his GDC reform letter highlighting anomalies in the system. He states that some dental professionals from the EU have been recruited as ‘dental assistants’, operating under their area manager’s NHS number. In his opinion, the requirement of ‘an assistant’ being ‘properly supervised’ in accordance with The Dentists Act was not being met.

Dentists who wish to practice in the UK, in my opinion broadly fall into three categories:

Dentists qualified in the UK

Dentists qualified overseas (non EU)

Dentists qualified in the EU/EEA.

UK dentists, upon graduation, have to complete a vocational training year in order to obtain a performers’ list number to practise in the NHS. This is mandatory. Similarly, overseas qualified dentists have to pass the rigorous overseas registration exam.

But when it comes to EU qualified graduates, they are free to practise without any of these constraints. So are we now assuming that all of the 28 countries within the EU have the same standard of dental education?

The NHS Careers website states: 'Dentists from the EEA, with a primary qualification specified in the relevant EC Directive, are able to register with the General Dental Council and practise in the UK on the basis of that qualification.' So there is clearly no level playing field.

There has been a lot written questioning the wisdom of those who were responsible for allowing this to be implemented.

My suggestion would be that there is a common statutory exam for all dentists not qualified in the UK prior to GDC registration. And this would eliminate any speculation regarding the credibility and calibre of the practitioner. Could this reduce the number of complaints?

In the last few days, it has been widely reported that the Care Quality Commission would be modifying its current system of regulating and inspecting primary dental care services, and it may introduce rating dental practices from 2016. Similarly, the Government has announced that from April 2015 every patient attending an NHS dentist will complete a 'Friends and Family Test'. This questionnaire asks patients whether they would recommend their dentist to their loved ones. It would be used to determine how well NHS practices are performing. The Health Secretary, Jeremy Hunt, emphasised that the aim is to enable ‘the NHS to be the most transparent healthcare system anywhere in the world'.

It would be interesting to see how this is going to impact on NHS dental practice.

Finally, I have to register my personal interest in medical/dental law and ethics. I would like to suggest a module on dento-legal practice, which explains the legal obligations of dentists to their patients and the consequences of non-compliance. This could be incorporated into the statutory exam, which I had previously suggested for dentists not qualified in the UK, and for UK graduates in the final year of the BDS programme.

If all the above is properly implemented, this will enhance the reputation of the dental profession and give confidence to patients.